Edge Physical Therapy and Sports Medicine LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01510100 Issued in NJ

Legal business name

EDGE PHYSICAL THERAPY AND SPORTS MEDICINE LLC

Practice address

16 Arcadian Way
Suite C6
Paramus, NJ 07652-1291

Phone

(201) 483-9523

Fax

(201) 483-9534

NPI assigned

Aug 17, 2015

Last updated

Jun 28, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lawrence Kim, PT, DPT, OCSNPI 1154755288

Title

Managing Director

Phone

(201) 482-9523

Specialties & licenses 1

Addresses

Tax ID family

Edge Physical Therapy and Sports Medicine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Edge Physical Therapy and Sports Medicine LLC

  • Physical Therapist
  • Paramus, NJ
  • NPI 1467828301
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lawrence Kim, DPT

  • Physical Therapist
  • Elmwood Park, NJ
  • NPI 1154755288
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1558737395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADIAN WAY",
            "address_2": "SUITE C6",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ARCADIAN WAY",
            "address_2": "SUITE C6",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521291",
            "telephone_number": "201-483-9523",
            "fax_number": "201-483-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE PHYSICAL THERAPY AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "201-482-9523",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01510100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Ebbighausen
• Christopher Ecochard, LAC, LCADC
• Eden Ambulance Corporation
• Edge Orthotics, Inc.
• Edge Physical Therapy and Sports Medicine LLC
• Edge Pro Sports Rehab Institute, LLC
• Aaron Ehrlich
• Emily Ehrmann, MA
• Julian Shigeki Ei, RN CDCES
• Sebastian Eid, MD

• Physical Therapist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.